Feds stage airport test of plan to slow pandemic

Nov 12, 2008 (CIDRAP News)  Officials from several agencies recently converged on Miami's international airport to take part in a full-scale exercise of the federal government's risk-based strategy to slow the spread of a future pandemic influenza virus across US borders.

Christine Pearson, a spokeswoman for the US Department of Health and Human Services (HHS), attended the first day of the 2-day drill on Nov 5 and told CIDRAP News that, unlike previous tabletop discussions to test the risk-based border strategy (RBBS), the exercise at Miami included a real plane and actors who played the role of passengers in an airport setting.

"It provided a level of realism that we hadn't had in past exercises, which had mostly been facilitated discussions," she said.

The RBBS is a short-term strategy that the federal government will use in the initial states of a pandemic to delay the spread of the virus enough to afford officials a little extra time to educate the public on how to protect themselves from the disease, produce and distribute vaccine, and position medication and supplies, Pearson said. The strategy involves screening international air passengers to gauge if they are sick or have potentially been exposed to others who are sick with the pandemic virus.

The system would begin when it's clear that a pandemic influenza virus is spreading globally and would end as soon as the virus begins causing illnesses in the United States.

Many public health experts have supported keeping borders open in a pandemic setting, because they don't believe closure would block the spread of the virus and because keeping borders open would preserve the flow of crucial supplies and soften a pandemic's impact on national economies.

Pearson said last week's drill was a joint exercise that involved the HHS, the Centers for Disease Control and Prevention (CDC), the Department of Homeland Security (DHS), Customs and Border Protection, the Department of Transportation (DOT), along with numerous state, local, and airline-industry partners.

The scenario involved a novel and lethal human influenza strain that emerged in Southeast Asia and spread quickly and efficiently among humans, she said. The playbook had the World Health Organization (WHO) identifying a human-to-human H5N1 variant that spread to areas of Thailand, Laos, Vietnam, and Cambodia. The WHO declared a severe (phase 6) pandemic, prompting the United States to raise its response stage to 3 and the secretaries of DHS, HHS, and DOT to enact nationwide RBBS activities.

She said Marty Cetron, director of the CDC's Division of Global Migration and Quarantine, was pleased with how the exercise went and said it exceeded his expectations, particularly how well the partners worked together.

It's likely that the RBBS in its current form will change, based on what officials learned during the exercise, Pearson said, adding "But by testing this now, we will help ensure that the plan we have in place will do what it's designed to do and will ultimately help us to protect the public's health during the next pandemic."

Federal officials routinely conduct drills at quarantine stations, Pearson said, and though additional activities are planned, no plans are in the works to do another large-scale exercise. Officials are likely to conduct more tabletop discussions that could include smaller drills to address certain parts of the RBBS plan.